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KHONGRUK WONGKITTIROCH D.O. NPI 1205003068


NPI Information

NPI: 1205003068
Provider Name: KHONGRUK WONGKITTIROCH, D.O.
Classification: Dermatology - 207N00000X
Entity Type: Individual
Organization: SKIN AND CANCER ASSOCIATES

PECOS Registration: Yes

Address:
2838 E OAKLAND PARK BLVD
STE 201
FORT LAUDERDALE, FL
ZIP 33306
Phone: (954) 564-0040
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Khongruk Wongkittiroch, D.O. is a dermatology in Fort Lauderdale, FL with 16 years of experience. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. Khongruk Wongkittiroch, D.O. NPI is 1205003068. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2838 E OAKLAND PARK BLVD
STE 201
FORT LAUDERDALE, FL
ZIP 33306-814
Phone: (954) 564-0040
Fax: (954) 564-0048

The NPI 1205003068 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Destruction of skin growth (HCPCS:17000)
  • Destruction of up to 14 skin growths (HCPCS:17110)
  • Biopsy of each additional growth of skin and/or tissue (HCPCS:11101)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (HCPCS:13132)

The enumeration date for this NPI number is 5/12/2008 and was last updated on 12/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyOS11792FLORIDAYes
2207ND0101XDermatologyMOHS-Micrographic SurgeryOS11792FLORIDANo
3207ND0900XDermatologyDermatopathologyOS11792FLORIDANo
4207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyOS11792FLORIDANo
5207NP0225XDermatologyPediatric DermatologyOS11792FLORIDANo
6207NS0135XDermatologyProcedural DermatologyOS11792FLORIDANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1261637814OTHERFLORIDAUNITED HEALTHCARE
2AL382ZMEDICARE PINFLORIDA
3261637814OTHERFLORIDAMULTI PLAN
46375863OTHERFLORIDACIGNA
5317129OTHERFLORIDAAVMED
628528OTHERFLORIDABLUE CROSS BLUE SHIELD OF FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.